Veterans have witnessed an extraordinary 2,300% surge in video-based telehealth post-pandemic, with audio-only visits returning to pre-pandemic levels. A detailed study, spanning from 2019 to 2023, examines outpatient encounters within the VA healthcare system. Notably, in-person visits declined sharply during the pandemic, paving the way for video visits to constitute 11% to 12% of outpatient care. Mental health services notably embraced video telehealth, accounting for 34.5% of visits by August 2023. However, disparities persist, impacting older adults, rural residents, and marginalized groups. The study urges ongoing research to evaluate the quality, safety, and health outcomes in this evolving healthcare landscape.
The seismic shift in healthcare dynamics amid the COVID-19 pandemic is evident in veterans’ adoption of telehealth. A recent study scrutinizes trends within the VA healthcare system from 2019 to 2023, revealing a staggering 2,300% surge in video-based telehealth usage post-pandemic. While audio-only visits have normalized, video visits continue to command 11% to 12% of outpatient care. The fluctuating landscape saw a sharp decline in in-person visits initially, with video visits becoming dominant. This comprehensive analysis sheds light on the evolving preferences across primary care, mental health, and subspecialty services, setting the stage for a nuanced exploration of telehealth’s future implications.
Telehealth Trends and Utilization:
A comprehensive study, recently published in the Annals of Internal Medicine, delves into the trends of in-person, audio-only, and video-based outpatient encounters within the VA healthcare system from 2019 to 2023. The researchers analyzed 277 million VA clinical outpatient visits, categorizing them by care service (primary care, mental health, or subspecialty care) and modality (in-person, audio-only, or video). The study reveals that, on average, the VA facilitated 1.14 million primary care, subspecialty, or mental health visits weekly, totaling 4.9 million visits monthly.
Pandemic Phases and Telehealth Adoption:
As the pandemic unfolded, in-person visits witnessed a drastic decline, plummeting from 81% of all visits in February 2020 to a mere 23% by May 2020. In the subsequent months, video visits emerged as a dominant modality, constituting 11% to 13% of all visits in 2023, a remarkable increase from the pre-pandemic level of 0.5%. Notably, in January 2021, in-person care regained dominance in primary care services.
By March 2021, in-person care volumes stabilized, marking the onset of a decline in the surge of video and audio-only visits. The combined utilization of audio-only and video-based telehealth declined from 79.6% of all visits in April 2020 to 36.7% in April 2023. Crucially, the decrease in telehealth use was primarily driven by a reduction in audio-only visits.
Video Telehealth in Specialized Care:
An intriguing aspect of the study is the insight into the distribution of video-based telehealth across different healthcare services. By August 2023, video-based telehealth accounted for 34.5% of mental health visits, 3.7% of subspecialty visits, and 3.5% of primary care visits. These findings underscore the evolving landscape of healthcare delivery, with mental health services demonstrating a substantial reliance on video telehealth.
Social Determinants of Health (SDOH) and Telehealth Disparities:
While the overall surge in video telehealth is notable, recent research has highlighted disparities in access and utilization, particularly concerning social determinants of health (SDOH) factors among veterans. One study, conducted in July 2023, revealed that urban veterans engaged in video visits more than their rural counterparts, with a particular focus on disparities faced by American Indian or Alaska Native veterans residing in rural areas. This suggests the presence of video telehealth access disparities that need careful consideration.
Additionally, the impact of broadband availability on video telehealth utilization has come to the forefront. A study published in October 2022 found that veterans with optimal broadband access participated in 16 additional video visits per 100 patients per quarter compared to those with inadequate broadband. This underscores the importance of addressing infrastructural limitations to ensure equitable access to telehealth services among veterans.
The surge in video-based telehealth utilization among veterans post-pandemic signifies a paradigm shift in healthcare delivery. While the overall numbers reflect a positive trajectory, it is crucial to recognize and address disparities in access, particularly among older adults, individuals in rural regions, and historically marginalized groups. Future research should not only continue monitoring telehealth trends but also delve into evaluating the quality, safety, and health outcomes associated with this new equilibrium in healthcare delivery. As the landscape continues to evolve, the pursuit of inclusive and effective telehealth solutions remains paramount in ensuring equitable healthcare access for all veterans.
